Dental Sales Flyer - March 2021 - 67

FEATURE

CLINICAL EXCELLENCE

JUST TAKE A MINUTE
A Step-By-Step Guide to Clinical Efficiency

By Todd C. Snyder,
DDS, FAACD
and Douglas Harvey,
BSc., DDS

Dr. Snyder received his doctorate
in dental surgery at the University
of California, Los Angeles (UCLA)
School of Dentistry and has
trained at the F.A.C.E. institute.
He is an Accredited Fellow of the
American Academy of Cosmetic
Dentistry and is a member of
Catapult Education. Dr. Snyder
was on the faculty at UCLA,
where he created and co-directed
the first 2-year graduate program
in aesthetic and cosmetic
restorative dentistry. In addition
to lecturing internationally, he
has written numerous articles in
publications around the world.

Dr. Douglas Harvey is a
consultant in Clinical Affairs
with Clinician's Choice Dental
Products. He has a Bachelor's
Degree in Biology and a Doctor
of Dental Surgery, both from the
University of Western Ontario.
He served as a dental officer at
the Canadian National Defence
headquarters before enjoying a
career in solo general practice
until 2015. Dr. Harvey has been
a long-standing member of the
International Dental Study Club,
and has served in organized
dentistry at the local and
provincial levels in Canada.

3

| Winter 2021 |

The sheer volume of information on dental materials and
techniques at our fingertips is staggering, but having the right
information is vital to providing the best care possible.

D

ental product marketing generally
promotes ease, speed, and cost savings as
an advantage to change but we need to filter
that information so that the techniques and
products that we choose reflects our patients' best
interests.
Chair time is the most valuable commodity in the
dental office, thus taking time to review treatment
protocols makes a lot of sense. However, balance
between clinical efficiency and continuing to provide
dentistry of the highest quality is critical to any change
you consider. Most of us get locked into a technique
that we simply accept as " works best in my hands " . If
we take a minute to consider the challenges that we
experience in our day-to-day dentistry, many can be
solved with just a small change in the technique or
product we use.
The anterior composite restoration continues to
improve in both its esthetic potential and efficiency
of placement. Each step of this procedure should be
considered, as current research and techniques show
capacity for significant improvement; in adhesion,
getting the most out of your composite, and the
development of a more effective finishing and
polishing technique. Just take a minute to break down
your anterior composite technique into its component
parts. Evaluate each step to determine if there are
some changes that can be made to improve both your
efficiency and clinical result.
Start by considering if your choice of phosphoric
acid is the optimal strength and viscosity. Runnier
H3PO4 gels tend to be more difficult to control during
placement, leading to potential sensitivity. As well,
many of us turned to self-etch adhesives due to postoperative sensitivity linked to the total-etch adhesive
technique and " how wet is wet " dilemma. While there
was far less sensitivity, I experienced some esthetic
challenges. Occasionally, white lines appeared at
the margin after polishing, and the formation of
marginal staining was sometimes noted due to the
inadequate pH of the self-etch adhesive. In hindsight,
the bond strengths of the 4th and 5th generation or
total-etch adhesives are considered the highest and
most enduring, compared to the later generations.
The simple addition of a glutaraldehyde-based
desensitizer helps to solve the question of " how wet
is wet, " as well as the post-operative sensitivity that

CLINICAL LIFE | clinicianschoice.com

is sometimes linked to the total-etch technique. Recent
research into MMPs and their bond degrading activity
makes it necessary to reconsider the choice of adhesive
in its ability to inhibit their effect. The adhesive technique
of choice should be easy to apply, universally compatible
with all substrates, and provide high, predictable bond
strengths that are resistant to MMP degradation. Just take
a minute and ask yourself if your adhesive choice satisfies
these requirements.

Dentistry and photography courtesy of Todd C. Snyder, DDS, FAACD.
All rights reserved by Dentistry Today.

Anterior preparations have generally required bevelling
to hide the margin and blend the restoration into the
surrounding tooth. Despite this, it was always disappointing
to go through a strict anterior composite regimen and still
see the margin after polishing. Some composite systems
today can provide the range of shades and opacities/
translucencies that enable the dentist to more easily blend
the restoration into the tooth with less layers. I remember
the frustration of having composite stick to my instrument,
resulting in pull-back or lifting off of the tooth when
trying to thin out the margin of the restoration or adapting
it into a preparation. Some of today's composites allow
for easy placement of an infinitely thin margin without
any pull-back. Coated instruments, available in many
tip forms and thicknesses, allow improved placement,
adapting, and sculpting of the composite. Would a change
in your composite material and instrumentation improve
your technique efficiency and composite restoration?


http://www.clinicianschoice.com

Dental Sales Flyer - March 2021

Table of Contents for the Digital Edition of Dental Sales Flyer - March 2021

Dental Sales Flyer - March 2021 - Cover1
Dental Sales Flyer - March 2021 - 2
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